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The psychosocial work environment is associated with risk of stroke at working age

Journal article
Authors Katarina Jood
N. Karlsson
J. Medin
H. Pessah-Rasmussen
P. Wester
K. Ekberg
Published in Scandinavian Journal of Work Environment & Health
Volume 43
Issue 4
Pages 367-374
ISSN 0355-3140
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 367-374
Language en
Keywords case control study, conflict at work, effort-reward imbalance, ERI, job strain, effort-reward imbalance, myocardial-infarction, job strain, decision, latitude, heart-disease, stress, men, metaanalysis, population, sweden, Public, Environmental & Occupational Health
Subject categories Clinical Medicine


Objective The aim of this study was to explore the relation between the risk of first-ever stroke at working age and psychological work environmental factors. Methods A consecutive multicenter matched 1:2 case control study of acute stroke cases (N=198, age 30-65 years) who had been working full-time at the time of their stroke and 396 sex- and age-matched controls. Stroke cases and controls answered questionnaires on their psychosocial situation during the previous 12 months. The psychosocial work environment was assessed using three different measures: the job control demand model, the effort reward imbalance (ERI) score, and exposures to conflict at work. Results Among 198 stroke cases and 396 controls, job strain [odds ratio (OR) 1.30, 95% confidence interval (95% CI) 1.05-1.62], ERI (OR 1.28, 95% CI 1.01-1.62), and conflict at work (OR 1.75, 95% CI 1.07-2.88) were independent risk factors of stroke in multivariable regression models. Conclusions Adverse psychosocial working conditions during the past 12 months were more frequently observed among stroke cases. Since these factors are presumably modifiable, interventional studies targeting job strain and emotional work environment are warranted.

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